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Living With Cancer: Playing the C Card

If you are dealt a crummy hand, you might find yourself playing the cancer card — even if other people object. I’ve come to believe that in certain cases, I not only could but should play the C card.

Before my mother died, I regularly needed to respond to an official document from the German government. A notary public had to certify her existence so she would receive the reparations sent to many Jews forced to flee the Nazis. Filling out the certificate — it was called the Lebensbescheinigung, or “proof of being alive” — always tripped me into irrationally intense distress, and not only because it reminded me of her displacement.

When, two months after the funeral, she was sent a proof-of-being-alive form, I threw it in the trash. That was the first time I played the C card. I had no wish to keep the money illicitly, but somehow mailing a letter with a death certificate felt deeply repugnant. At a later date, I simply returned a check with a Post-it recording her date of death. Cancer served as my excuse for not responding properly.

The word “Lebensbescheinigung” reminds me that I am the one who, given enervating cancer treatments, sometimes needs to prove to myself that I am alive. Although medical protocols exert enormous control over my existence, the C card offers me a chance to exploit cancer for my own purposes. I have played it quite a bit: to not participate, to not travel, to not stay on the phone with my recriminatory aunt, to not do or say or eat anything I don’t want to do or say or eat, to split infinitives. I can relate to Melville’s Bartleby the scrivener: I frequently prefer not to.

Many people living with cancer use it as a ticket to reform their lives, for example, by delegating stressful responsibilities. It gives them permission to engage in productive enterprises like starting a walking regimen or volunteering for a patient advocacy group. But if you have lost your prediagnosis occupations and your life is a gamble, the C card can additionally serve as a license to disregard the consequences.

Why worry about your cholesterol or a savings account? Why not go ahead and reserve a weekly table at the best ice cream parlor in your neighborhood or purchase exorbitant tickets for a monthlong cruise of Alaska while you can still enjoy it? Instant gratification, generally derided as shortsighted, can make sense to cancer patients who may also exploit the sympathy elicited by the visible effects of treatment.

According to a memoir of the stand-up comedian Robert Schimmel, he and his wife were speeding to the hospital when a policeman stopped them. Mr. Schimmel imagined what the officer was thinking: “Damn. This guy looks like,” followed by an expletive. “What if he’s dying, chemo’s his only hope, and he misses his treatment because I’m writing him a speeding ticket? I might be costing him his life. Do I want that on my head? That could send me straight to hell.” Cancer lets Mr. Schimmel off the hook; it is “the ultimate Get Out of Jail Free card.”

For others, the C card stands for carpe diem. Whether you love fly-fishing, pedicures, rock music, photography, Bora Bora, playing with the dog, drinking, bowling, or bowling while drinking, after a cancer diagnosis you may finally find the time to follow your desires. Mine are sedentary and luckily inexpensive: reading, writing, cooking for my children and stepchildren when they come to stay, visiting with friends, trembling with my husband through college basketball games on television.

There are moments, though, that I hate a deck stacked with C cards. When my friend Jo needed to travel to Indianapolis for a needle biopsy, I realized that this would be the first time I could not support her through a medical event. For some 30 years, I had been the designated caretaker through every one of her operations. But weakened by too many treatments, I was in no shape to drive her to and from the hospital.

The night after Jo told me that she would have insisted that I not accompany her, I had a brief dream. In it, the phone rang, and it was Jo. She said only my first name, but her voice cracked. I woke, distressed.

The next day, Jo responded to my account. “Sunt lacrimae rerum,” she said. “These are the tears of things.” That is one reason she’s a wonderful friend. Here’s another: Jo understands the source of my loathing of legal forms.

Throughout my mother’s perilous passage from Nazi Germany to America, she had been tormented by the need for certification: the official seals on identity cards and work licenses, the red tape of permits and passport applications, the multiple copies of affidavits of sponsors. Once here, on paper (in file cabinets, then overflowing into piles stacked everywhere in her apartment) but also (thank goodness) in person, she finally established and relished abundant proof that she was fully alive.

The hand my mother had been dealt was far worse than mine.

A version of this article appears in print on 12/23/2014, on page D4 of the NewYork edition with the headline: Playing the C Card.